The proposed four-year study requests funds to extend the scope of our ongoing research on the mental health of Cambodian refugees. The baseline study recruited a household, probability sample of residents from the largest single community of Cambodian refugees in the US. The findings from the baseline study revealed high levels of psychopathology, high levels of mental health service seeking, poor self-rated physical health, and low socioeconomic status among Cambodian refugees. These poor psychological, physical and financial outcomes, occurring more than two-decades after resettlement, suggest a need for improvement in the integration and treatment of refugee populations. The proposed research is designed to provide an empirical basis for making these improvements. The proposed research would attempt to re-interview all 527 participants approximately 4 years after the baseline interview. As before, all interviews would be conducted in Khmer by trained lay interviewers, and take place in participants' homes. Participants would also be asked to provide a blood sample to assess risk factors for stroke. Additional information would be gleaned from focus groups with service providers and review of service records. The application has three specific aims: (1) To identify possible changes in mental health treatments that would improve the psychological outcomes of refugees; (2) To determine the extent to which trauma exposure, and its psychological sequelae, affect the physical health of refugees; and (3) To document the temporal sequence underlying the observed co-occurrence of low socio-economic status (SES) and mental health problems in refugee populations. The proposed research is directly relevant to two of the highest priorities of NIMH: relieving the suffering of people with mental disorders and identifying new approaches to address the needs of special populations. The US admitted more than 2.4 million refugees since 1980, many of whom have psychological problems associated with their traumatic experiences. Documenting the potential impact of trauma exposure and its sequelue on physical and socioeconomic well- being, and identifying possible areas for improvements of mental health treatments for refugees are public health issues of paramount importance. PUBLIC HEALTH RELEVANCE: Large numbers of Cambodian refugees suffer from poor mental health, poor physical health, and low socioeconomic status, more that two decades after resettlement in the US. The proposed research seeks to provide information needed to improve mental health services offered to this refugee group. The results of this study should also be applicable to other current and future refugees.